vi

DAFTAR ISI

HALAMAN JUDUL ................................................................................................ i

HALAMAN PENGESAHAN ................................................................................. ii

SURAT PERNYATAAN....................................................................................... iii

PRAKATA ............................................................................................................. iv

DAFTAR ISI .......................................................................................................... vi

DAFTAR TABEL ................................................................................................ viii

DAFTAR GAMBAR ............................................................................................. ix

DAFTAR SINGKATAN ........................................................................................ x

DAFTAR LAMPIRAN .......................................................................................... xi

INTISARI .............................................................................................................. xii

BAB I PENDAHULUAN .................................................................................. 1

1.1. Latar Belakang ................................................................................. 1

1.2. Rumusan Masalah ........................................................................... 3

1.3. Tujuan Penelitian ............................................................................. 3

1.3.1. Tujuan Umum ...................................................................... 3

1.3.2. Tujuan Khusus ..................................................................... 3

1.4. Manfaat Penelitian ........................................................................... 4

1.4.1. Teoritis ................................................................................. 4

1.4.2. Praktis .................................................................................. 4

BAB II TINJAUAN PUSTAKA ......................................................................... 5

2.1. Hepatotoksisitas imbas obat anti tuberkulosis ................................. 5

2.1.1. Definisi ................................................................................ 5

2.1.2. Epidemiologi ....................................................................... 5

2.1.3. Patogenesis .......................................................................... 6

2.1.4. Gambaran klinis ................................................................. 11

2.1.5. Faktor Resiko ..................................................................... 12

2.2. Obat anti tuberkulosis .................................................................... 16

2.2.1. Isoniazid (INH) .................................................................. 17

2.2.2. Rifampisin ......................................................................... 18

vii

2.2.3. Pirazinamid ........................................................................ 19

2.3. Tatalaksana hepatotoksisitas imbas obat anti tuberkulosis ........... 20

2.4. Kerangka Teori .............................................................................. 22

2.5. Kerangka Konsep .......................................................................... 23

2.6. Hipotesis ........................................................................................ 24

BAB III METODE PENELITIAN ..................................................................... 25

1.1. Rancangan penelitian ..................................................................... 25

1.2. Variabel Penelitian dan Definisi Operasional ............................... 25

1.2.1. Variabel Bebas ................................................................... 25

1.2.2. Variabel Tergantung .......................................................... 25

1.2.3. Definisi Operasional .......................................................... 25

1.3. Populasi dan Sampel Penelitian ..................................................... 26

1.3.1. Populasi ............................................................................. 26

1.3.2. Sampel Penelitian .............................................................. 27

1.4. Instrumen ....................................................................................... 29

1.5. Cara Penelitian ............................................................................... 29

1.6. Tempat dan Waktu ........................................................................ 30

1.6.1. Tempat Penelitian .............................................................. 30

1.6.2. Waktu Penelitian ................................................................ 30

1.7. Analisis Hasil ................................................................................. 30

1.7.1. Analisis univariat ............................................................... 30

1.7.2. Analisis bivariat ................................................................. 30

BAB IV HASIL DAN PEMBAHASAN ............................................................ 32

4.1. Hasil Penelitian .............................................................................. 32

4.2. Pembahasan ................................................................................... 35

BAB V KESIMPULAN DAN SARAN ............................................................ 39

5.1. Kesimpulan .................................................................................... 39

5.2. Saran ........................................................................................... 39

DAFTAR PUSTAKA ........................................................................................... 40

LAMPIRAN ........................................................................................................... 43

viii

DAFTAR TABEL

Tabel 2. 1 Derajat hepatotoksisitas imbas obat menurut Common Toxicity

Criteria .................................................................................................. 5

Tabel 2. 2 Batasan IMT untuk penilaian status gizi penduduk dewasa ............... 14

Tabel 4.1. Distribusi frekuensi variabel penelitian Faktor Resiko Kejadian

Hepatotoksisitas Imbas OAT .............................................................. 32

Tabel 4.2. Analisis bivariat faktor resiko hepatotoksisitas imbas OAT di RSI

Sultan Agung Semarang tahun 2013 – 2017 ....................................... 34

ix

DAFTAR GAMBAR

Gambar 2. 1 Mekanisme hepatotoksisitas imbas obat ........................................... 11

Gambar 2. 2 Jalur metabolisme isoniazid .............................................................. 17

Gambar 4. 1 Distribusi hepatotoksisitas imbas OAT menurut usia, jenis

kelamin dan status gizi ................................................................... 33

x

DAFTAR SINGKATAN

ALT : Alanin Aminotransferase

AST : Aspartat Aminotransferase

BAN : Batas Atas Normal

BTA : Basil Tahan Asam

DILI : Drug Induced Liver Injury

IMT : Index Massa Tubuh

INH : Isoniazid

OAT : Abat Anti Tuberkulosis

RSI : Rumah Sakit Islam

xi

DAFTAR LAMPIRAN

Lampiran 1 Data Penelitian ................................................................................... 43

Lampiran 2 Deskripsi Karakteristik Sampel Penelitian ........................................ 44

Lampiran 3 Tabulasi Silang Hubungan Usia dengan Hepatotoksisitas Imbas Obat

Anti Tuberkulosis ............................................................................... 45

Lampiran 4 Tabulasi Silang Hubungan Jenis Kelamin dengan Hepatotoksisitas

Imbas Obat Anti Tuberkulosis ........................................................... 47

Lampiran 5 Tabulasi Silang Hubungan Status Gizi dengan Hepatotoksisitas Imbas

Obat Anti Tuberkulosis ...................................................................... 48

Lampiran 6 Surat Permohonan Ijin Penelitian ...................................................... 49

Lampiran 7 Surat Jawaban Ijin Penelitian ............................................................ 50

Lampiran 8 Surat Keterangan Selesai Penelitian .................................................. 51

Lampiran 9 Ethical Clearance .............................................................................. 52

Lampiran 10 Dokumentasi .................................................................................... 53